pharmacology (all)

Question 1

what is the first drug therapy that should be used with patients with hypertension

Answer 1

thiazide diuretics (hydrochlorothiazide)

Question 2

how can hypertension be resolved without drug therapy

Answer 2

diet
stop smoking
less salt
exercise

Question 3

after thiazide diuretics, what is the next logical pharmacuetical option for hypertension

Answer 3

ACE inhibitors

Question 4

how do ACE inhibitors work

Answer 4

they inhibit angiotensin converting enzyme from synthesizing angiotensin 2, a potent vasoconsrictor. angiotensin 2 also causes aldosterone to be secreted. which is an antidiuretic. increasess blood volume and pressure

Question 5

what do ACE inhibitors end in

Answer 5

-pril

Question 6

what do angiotensin 2 receptor blockers end in

Answer 6

-sartan

Question 7

what is the benefit of angiotensin 2 blockers over ACE inhibitors

Answer 7

they don’t cause a dry cough

Question 8

what is the adrenergic drug for hypertension that can be used in pregnancy

Answer 8

clonidine (catapres)

Question 9

how do beta blockers work

Answer 9

they reduce heart rate by blocking beta receptors in the heart. they also reduce renin secretion, thus aldoseterone II and angiotensin
decrease blood pressure

Question 10

can patients abruptly stop taking antihypertension medication

Answer 10

no because it can cause a rebound hypertensive effect, which can lead to a stroke

Question 11

what do calcium channel blockers end in

Answer 11

ipine

Question 12

what drug is used for a hypertensive emergency

Answer 12

sodium nitropresside (nitride) and IV diazoxide (they are peripheral vasodilators

Question 13

what causes angina pectoris

Answer 13

insufficient oxygen to the heart

Question 14

what are the three types of angina

Answer 14

chronic stable (classic or effort) angina
unstable (preinfarction) angina
vasospastic (prinzmetals) angina

Question 15

what are the characteristics of stable angina

Answer 15

no pain while resting
pain starts by exercise, stress, emotion or heavy metals
caused by atherosclerotic plaques

Question 16

what are the characteristics of unstable angina

Answer 16

unpredictable even at rest
more intense pain longer lasting
risk MI and death
caused by atherosclerotic plaque rupture/blockage

Question 17

what are the characteristics of vasospastic angina

Answer 17

caused by intense coronary arterial spasms
pain may come at rest
smoking, hyperinsulinemia, and insulin resistance are factors

Question 18

what are nitrates for

Answer 18

they are used to prevent angina, since they cause potent dilation of coronary arteries. they are used for acute angina, and prevention of angina

Question 19

what is the main side effect of nitrates

Answer 19

headaches (also orthostatic hypotension)

Question 20

what is the most common calcium channel blocker

Answer 20

niphedipine (procardia)

Question 21

what is the most common side effect of niphedipine

Answer 21

constipation (tell them to eat fiber)

Question 22

what is nitroglycerine for

Answer 22

it is a vasodilator that decrease bp and helps with angina

Question 23

what is the process for taking nitroglycerine with angina

Answer 23

when angina occurs, sit down and take one sublingually. wait five minutes, take another if angina persists. call 911 get an ambulance. take third 5 minutes later if angina persists

Question 24

when should you not give someone nitroglycerine

Answer 24

with someone who has a systolic blood pressure below 90

Question 25

what type of drugs are used for long term management of angina

Answer 25

beta blockers and calcium channel blockers

Question 26

what type of drugs are used for acute angina management

Answer 26

nitroglycerines

Question 27

what is a mild diuretic

Answer 27

thiazide

Question 28

what is a powerful diuretic

Answer 28

forosimide (lacic)

Question 29

what should be instructed of patients taking diuretics

Answer 29

increase electrolytes, especially potassium

Question 30

what are potassium sparing diuretics

Answer 30

spirolactone and aldolactone

Question 31

what shouldn't be done with potassium sparing diuretics

Answer 31

you shouldn't increase potassium (can lead to hyperkalemia)

Question 32

when should diuretics be taken

Answer 32

in the morning (don't wake up to pee)

Question 33

what is the drug of choice for ventricular dysrhythmias

Answer 33

lidocaine,xylicaine

Question 34

why is a beta blocker a bad idea for a women with a slow heart beat

Answer 34

because they slow down the heart rate

Question 35

what is a dysrhymia

Answer 35

any deviation from the normal rhythm of the heart

Question 36

what causes dysrhythmias

Answer 36

ischemia/MI toxicants drugs hypokalemia

Question 37

what is the normal level of digoxin

Answer 37

.5-2 ng/dl

Question 38

what are the effects of digoxin

Answer 38

positive ionotrope negative chromotrope negative dronotrope

Question 39

what are the side effects of digoxin overdose

Answer 39

``` nausea diarrhea vomiting seeing halos hypokalemia ```

Question 40

what happens with digoxin and a diuretic

Answer 40

hyperkalemia

Question 41

what things shouldn't someone on warfarin/coumadin do

Answer 41

anything that can cause bleeding | shaving, flossing

Question 42

what tests are used to test the effects of warfarin

Answer 42

prothrombin time and INR | PT-INR

Question 43

what are the signs and symptoms of serious side effects of warfarin

Answer 43

``` bleeding skin rashes fever nausea diarrhea dermatitis alopecia urticaria abdominal cramps anorexia ```

Question 44

what pain killer should be taken with warfain/coumadin

Answer 44

tylenol/acetometaphen

Question 45

what is the antidote for warfarin/coumadin

Answer 45

vitamin K

Question 46

what is the mechanism of action for anticoagulants

Answer 46

prevent clot formation, don't break down current clots

Question 47

why would LMWH be administered

Answer 47

because it has a more predictable anticoagulant response it doesn't require prolonged aPTT it doesn't require prolonged lab tests

Question 48

what is LMWH

Answer 48

low molecular weight heparin

Question 49

what is the lab test used to monitor heparin effects

Answer 49

aPTT activated partial thromboplastin time

Question 50

what is the first choice antiplatelet drug

Answer 50

aspirin, because it is the least powerful

Question 51

why do we use clopdogrel

Answer 51

its a powerful antiplatelet that we use so we don't have to use an anticoagulant

Question 52

at what point do we call a doctor if on antihypertensive drugs and we are in hypotension

Answer 52

if systolic is less than 90

Question 53

what must we caution our patient about antihypertensive drugs,

Answer 53

they need to watch for orthostatic hypotension

Question 54

what is primary hypertension

Answer 54

idopathic, cause unknown

Question 55

what is secondary hypertension

Answer 55

hypertension due to a secondary cause, it goes away once the other problem is fixed

Question 56

concerning pulse, when should we call the doctor

Answer 56

if its less than 60 or more than 100

Question 57

when taking calcium channel blockers what tests do we check to observe renal function

Answer 57

BUN and creatinine

Question 58

what is verapamil

Answer 58

calcium channel blocker

Question 59

ways to reduce cholesterol

Answer 59

diet | exercise

Question 60

what is the first line drug of choice for hypercholesterolemia

Answer 60

statins

Question 61

what are ideal LDL values

Answer 61

less than 100 (190 is very high)

Question 62

what are ideal HDL values

Answer 62

more than 60 (less than 40 is bad)

Question 63

what are ideal total cholesterol values

Answer 63

less than 200 (more than 240 is bad)

Question 64

treatment for digoxin overdose

Answer 64

digoxin immune fab (digibind) therapy